中西医结合疗法在肾移植术后并发结核病中的应用

The application of integrated chinese and western medicine therapy in the treatment of tuberculosis after renal transplantation

[目的]分析总结肾移植术后并发结核病的临床特征、诊治和预后。[方法]回顾性分析2005-2006,2015-2016在河南中医药大学第一附属医院泌尿外科肾移植科收治的肾移植术后并发结核病16例患者。[结果]根据患者的临床表现、实验室检查、胸部CT、组织活检以及抗结核治疗的阳性反应等明确诊断,并积极规律、联合、适量、全程应用抗结核药物,疗程一般6~12月。同时合理调整免疫抑制剂,予以中成药五酯胶囊护肝和积雪草制剂延缓移植肾慢性病变进展等中西医结合疗法。16例肾移植术后并发结核病患者均存活好转,未出现死亡病例,未出现排斥反应,随访1年以上未复发。[结论]肾移植术后结核病的诊疗关键是早发现、早诊断、早治疗,同时预防排斥反应,减少相关并发症,保证用药安全性,减轻患者经济负担。

[Objective ]To analyze the characteristics of tuberculosis （TB） in renal-transplant recipients, and summarize the corresponding experiences in diagnosis and management and prognosis.〔 Metliods 〕 A retrospective study was performed on 16 TB patients from the First Affiliated Hospital of henan college of traditional Chinese medicine between June. 2005 and June. 2014. [Results] According to the patient ^ s clinical feature, laboratory examination, chest CT, biopsy and positive reaction of antituberculosis therapy, we could diagnose. All patients followed law, full, right amount, combined with principles of anti-tuberculosis treatment, and treatment usually lasted for 6-12 months. They were given adjustment of immunosuppressive agents, advanced liver protection and delayed graft chronic disease progress by applying the Chinese patent medicine. Eleven patients were alive, no deaths, no immunological rejection, followed up for more than one year without recurrence. [Conclusion]It was early discovery, early diagnosis, early treatment that key determinants of diagnosis and treatment of TB in renal-transplant recipients, meanwhile prevented rejection, reduced the related complications, ensured medication safety and lightened the financial burden.